What is the menopause?
The menopause is a natural event and occurs when your ovaries stop producing eggs and, as a result, the levels of your hormones called oestrogen and progesterone fall. Menopause actually means your last menstrual period. It is often difficult to know when this is for many women, especially if you are having more scanty and irregular periods.
The term ‘perimenopausal’ is often used, which describes the time when you have menopausal symptoms in the months or years before your periods have actually stopped altogether. Some women continue to have regular periods even though they experience numerous symptoms of the menopause.
Women are said to have gone through their menopause when they have not had a period at all, for one year – described as postmenopausal.
The average age of the menopause in the UK is 51 years. It is common to have some perimenopausal symptoms when you are in your late 40s.
What are the common symptoms of the menopause?
Some women have very few or even no symptoms, and their periods simply stop happening. However, for the majority of women it is not so straightforward; around 80% of all women experience several menopause symptoms. These symptoms often have a very negative impact on your life and can really affect your relationships with your partner, family and work colleagues.
Symptoms vary from woman to woman but can include hot flushes, night sweats, mood swings, sleep disruption, lack of libido, and poor concentration. Other less well known, but equally as common symptoms are joint pain, changes to hair and skin, depression, anxiety and panic attacks, poor memory, brain ‘fog’, dry eyes and mouth, vaginal dryness, urinary symptoms, palpitations, chest pain and breathlessness, and headaches or migraines.
How is the skin affected during the perimenopause and menopause?
Oestrogen is very important for the development of collagen - a supporting protein found in the skin - and provides strength and structure to it.
As oestrogen levels reduce during the menopause and perimenopause, your skin can become less mobile and thinner. Low oestrogen levels can result in there being less blood flowing to the epidermis (upper layer of your skin) and more water lost from your skin - leading to your skin being less hydrated. You may notice that your skin looks tired and develops more fine lines and wrinkles. The skin often loses elasticity and appears less glowing, as hormone levels decline.
Your skin can become dry and feel itchy. This itchiness can occur during the day and night and be really troublesome. Some women notice abnormal sensations to their skin, such as numbness, tingling, prickling or a crawling sensation (called formication).
During the perimenopause and menopause, many women also experience acne and skin pigment changes.
Does the skin become more sensitive to the effects of the sun?
Menopausal skin is more susceptible to UV damage causing deeper wrinkling and sun damage; like age spots and lentigo - which are small brown spots on the skin.
The maintenance of melanocytes (cells that manufacture the pigment melanin) is controlled by oestrogen. The number of melanocytes in your skin reduces during the perimenopause and menopause, resulting in less protective melanin - so your skin can appear lighter. Menopausal skin is therefore more prone to sun damage.
In areas of the skin that have been exposed to UV rays over the years, melanin synthesis increases during the menopause. This can result in brown age spots appearing on your face, hands, neck, arms and chest.
What are the best ways of looking after your skin during the perimenopause and menopause?
It is really important to use a good moisturiser regularly, to improve your skin's hydration. Moisturisers smooth and protect the upper layers of your skin and can work to prevent the body losing water through the skin (trans-epidermal water loss).
It is essential that you use a sunscreen with a minimum SPF 30 to protect against UVB rays and avoid sun damage. Sunscreen should be reapplied every few hours and you should also consider wearing a wide-brimmed hat.
HRT and effects on skin
Hormone replacement therapy (HRT) can improve skin hydration by replacing oestrogen levels in your body. Many women who take HRT often notice that their skin becomes brighter, with an improved texture and tone. HRT can also reduce ageing of your skin; it often looks firmer and plumper as the oestrogen works to strengthen the collagen and elastin fibres.
For the majority of women under 60 years of age, the benefits of HRT outweigh the risks – take a look at our factsheets for more information about the risks and benefits of HRT.